HOME >> MEDICINE >> NEWS
Doctors steer sick patients away from capitated HMOs

Quality concerns drive inadvertent 'cherry picking'

Many doctors unwittingly are helping managed care plans cherry pick healthier patients, while sicker patients are being steered toward safety-net providers, according to a new study.

In a national survey of 787 physicians, 40 percent reported encouraging patients who are sicker or who have more complex illnesses to avoid capitated managed care plans, in which doctors receive a flat monthly rate per patient. At the same time, 23 percent reported encouraging healthier patients to join such plans, finds the study published in the January issue of the Journal of General Internal Medicine.

Although the data dont clearly identify whether it is cost or quality considerations alone that motivate them to make such recommendations, the study shows that physicians are contributing to risk selection among capitated managed care plans, raising legal, ethical and policy issues, according to author Matthew K. Wynia, M.D., M.P.H., of the American Medical Associations Institute for Ethics.

On the one hand, medical leaders have suggested that physicians ought to help their patients make [health plan] selections, because assisting patients in this way is an important form of physician advocacy, the authors note.

Unfortunately, this study shows that even well-intentioned physician advice may foster risk selection, say Wynia and colleagues. Risk selection undermines insurance pools by causing disproportionate enrollment of less costly patients into certain health plans. This is expensive for some payers, who overcompensate health plans with healthier-than-expected enrollees and financially risky for providers who do not or cannot risk-select, such as safety net providers.

Physicians also were asked whether they felt capitated payment plans undermined their ability to offer a quality of care equal to that of other types of managed care reimbursement. One-third of the surveyed
'"/>

Contact: Ross Fraser
312-464-4443
Center for the Advancement of Health
12-Jan-2002


Page: 1 2

Related medicine news :

1. Doctors need to prepare for blood shortages now
2. Doctors must consider potentially inappropriate medications when treating elderly
3. Doctors transplant ovary to womans arm to preserve fertility
4. Doctors can improve colorectal cancer screening rates
5. Doctors miss chances to provide diet, exercise counseling to patients at risk of heart disease
6. Doctors and patients call on politicians to save lives of cancer patients
7. Doctors dont agree on diagnosis of uterine cancer
8. Doctors at Northwestern Memorial are studying next generation surgery for back pain sufferers
9. U-M study: Doctors more likely to prescribe pricey new blood pressure drugs
10. Doctors over-estimate survival of terminally ill patients
11. Doctors are often strongly affected by patient deaths

Post Your Comments:
*Name:
*Comment:
*Email:


(Date:1/24/2017)... ... 24, 2017 , ... Inspiration, Community & Mentorship – Top ... the Fordham Institute’s High Stakes for High Achievers offer recommendations for ... or high-achieving students as a subgroup and reporting their results separately. Top students ...
(Date:1/24/2017)... Pass, OR (PRWEB) , ... January 24, 2017 ... ... Gerald H. Pollack, Ph.D., http://www.faculty.washington.edu/ghp , Sharon Kleyne, the nation’s foremost ... of Water, Global Climate Change and Your Health on Voice America, once again ...
(Date:1/24/2017)... ... 24, 2017 , ... A yellow fever outbreak in Brazil has infected over ... is primarily spread through contact with infected mosquitos. The outbreak has sparked increased concern ... spread. , According to multiple health organizations, the best way to prevent yellow fever ...
(Date:1/24/2017)... ... January 24, 2017 , ... ... topics like finances, friendship, marriage, leadership, gossip, prostitution, adultery, anger, and common sense. ... authors, Dr. Judith Coats and Dr. David Coats. In September of 1983, they ...
(Date:1/24/2017)... (PRWEB) , ... January 24, 2017 , ... “Mysteries Revealed ... to be a mysterious phenomenon is available to all Christians. “Mysteries Revealed On Speaking ... host of “U Beautiful Creation,” a Christian-based talk show located in Michigan. , ...
Breaking Medicine News(10 mins):
(Date:1/24/2017)... , Jan. 24, 2017 Mezzion has filed ... Jersey State court alleging that Dr. Reddy,s committed fraud ... Food and Drug Administration (FDA) cGMP practices, and misrepresenting ... Reddy,s repeatedly represented to Mezzion that it was compliant ... from Mezzion.  The suit also states that Dr. Reddy,s ...
(Date:1/24/2017)... , January 24, 2017 The global  active pharmaceutical ... billion by 2025, based on a new report by Grand View Research, ... projected to drive the market over the forecast period. Advancements in recombinant ... estimated to boost growth.  Continue Reading ... ...
(Date:1/24/2017)... , January 24, 2017 Aptuit, ... Molecular Surgical Laboratory des Massachusetts General Hospital (MGH) unter ... geht es um die Identifizierung und Validierung neuartiger Targets ... dass sie der Resistenz von Antibiotika bei der Behandlung ... ...
Breaking Medicine Technology:
Cached News: